Objective To investigate the association between podocytes and proteinuria in children with Alport syndrome. Methods Twenty-one children including 13 boys and 8 girls with Alport syndrome were divided into 3 groups according to 24-hour urinary protein, ＜30 mg/kgas the mild proteinuria group (10 patients), 30 to 50 mg/kg as the moderate proteinuria group (4 patients) and ＞50 wg/kg as the heavy proteinuria group (7 patients). The correlation between foot process width and the degree of proteinuria was analyzed. By immunoperoxidase staining on renal tissue, the key slit diaphragm molecules nephrin, podocin and podocyte cytoskeleton-associated molecule synaptopodin were studied. Results The foot process width (420-2270 nm) in patients with Alport syndrome was positively correlated with proteinuria significantly (r=0.765, P＜0.01).Foot process width was significantly lower in patients with mild proteinuria [475 (420-900) nm)compared with that in patients with heavy proteinuria [1520 (480-2270) nm] (P＜0.05). In Alport syndrome children with heavy proteinuria, the distribution of nephrin and podocin changed dramatically. In two children with shorter proteinuria period (1 year), dramatic distribution change of nephrin and podocin occurred, however, the foot process along with synaptopodin preserved.Conclusions Podocyte foot process effacement and injury of slit diaphragm participate in the mechanism of proteinuria in Alport syndrome. The injury of slit diaphragm seems to be an early event in the development of foot process effacement in Alport syndrome, which may guarantee early treatment.

Objective To investigate whether blocking NR2B receptor can reverse the process of cytotoxicity to spiral ganglion neurons induced by sodium salicylate in guinea pig by applying ifenprodil (a NR2B antagonist) at the round window niche .Methods Sixty healthy guinea pigs provided by the experimental animal center of Guangxi medical university were randomly and evenly divided into a control group (Group I ,no treatment) ,an APL group (Group II ,60μl APL directly applied to the round window ) ,a sodium salicylate group (Group III ,60 μl APL di-rectly applied to the round window and then be given intraperitoneal sodium salicylate injection ) ,and an ifenprodil group (Group IV ,60μl of 10μmol/l ifenprodil in APL directly applied to the round window and then be given intra-peritoneal sodium salicylate injection ) .Sodium salicylate was given at 400 mg · kg -1 · d-1 for 7 days .Auditory brainstem responses (ABRs) were recorded before animal sacrifice by decapitation .The left cochlea was removed and prepared for detection of caspase -3 expression in spiral ganglion neurons via immunohistochemistry .From each group ,6 cochleae were used to test apoptosis index in spiral ganglion neurons using the TUNEL technique .Results Before salicylate administration ,the ABR threshold was less than 40 dB SPL in all animals .After salicylate ad-ministration ,the ABR threshold was 33 .33 ± 5 .17 dB SPL in Group II ,64 .17 ± 7 .36 dB SPL in Group III and 49 .17 ± 5 .85 dB SPL in Group IV ,in contrast to 31 .67 ± 5 .16 dB SPL in Group I (controls) .The caspase -3 ex-pression was not changed obviously in Group I and Group II ,but was significantly changed in Group III and Group IV (P<0 .01) .The caspase-3 expression appeared to be decreased in Group IV compared to those in Groups III (P<0 .05) ,but still increased compared to those of in Group I and II (P<0 .05) .The apoptosis index among spiral ganglion neurons in Groups III and IV increased significantly compared to those of in Group I and II (P<0 .001) .It was however ,lower in Group IV than in Group III (P<0 .01) .Conclusion Blocking NR2B receptor with specificity can reverse the process of cytotoxicity to spiral ganglion neurons induced by sodium salicylate in guinea pig .

BACKGROUND:Vertebroplasty and kyphoplasty have been widely applied in the treatment of osteoporotic thoracolumbar compression fracture. However, cement leakage is a major problem in the application of this technology, especial y for the vertebral posterior wal ruptured patients. OBJECTIVE:To investigate the therapeutic efficacy of high viscosity bone cement and vertebroplasty in the treatment of osteoporotic thoracolumbar compression fracture. METHODS:A retrospective study was conducted in 20 cases receiving high viscosity bone cement and vertebroplasty surgery for osteoporotic thoracolumbar compression fracture. Clinical outcomes were evaluated mainly with use of Visual Analog Scale for lower back pain. Function of lower back pain was assessed using Oswestry Disability Index questionnaire. Quality of life was evaluated using 36-Item Short Form Health Survey and Frankel score was applied to evaluate neurological function. The anterior vertebral height of the fractured vertebrae was assessed with X-ray. The bone cement leakage, pulmonary embolism, incidence of nearby vertebral fractures and other complications were evaluated during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-18 months. The anterior vertebral height of the fractured vertebrae, the lower back pain and function, and quality of life were improved significantly after treatment (P<0.05). Al patients got the same neurological symptoms before surgery. The bone cement dispersion was good after treatment, detected by X-ray and CT scan, only two cases appeared with bone cement leakage, but no clinical symptoms were found. There was no cement toxicity or al ergic complications, pulmonary embolism, infection, nerve injury or new fractures. The high viscosity bone cement used in the treatment of osteoporotic thoracolumbar vertebral compression fractures can significantly relieve thoracic back pain, improve lower back function and quality of life, and greatly reduce the risk of bone cement leakage.

BACKGROUND:Statins can promote the mRNA expression of bone morphogenetic protein 2, aggrecan and type II col agen in intervertebral disc cel s, and they also can reverse the phenotype of dedifferentiated nucleus pulposus cel s to slow disc degeneration process. OBJECTIVE:To review the research progress of simvastatin modulating the biological characteristics and mobilizing endogenous stem cel s for the repair of intervertebral disc degeneration. METHODS:The first author retrieved the PubMed and CNKI databases for relevant articles published before January 2016 using the key words of“disc degeneration factor, Simvastatin AND stem cel s, endogenous stem cel s AND disc degeneration”in English and Chinese, respectively. Initial y, 102 relevant articles were retrieved, but only 48 articles were included in result analysis fol owing elimination of duplicate studies.RESULTS AND CONCLUSION:By summarizing a large number of studies on the treatment of intervertebral disc degeneration worldwide, we found that simvastatin may modulate the biological characteristics and function of nucleus pulposus mesenchymal stem cel s via promoting the expression of hypoxia-inducible factor 1αfor the endogenous stem cel-based therapy of intervertebral disc degeneration.

BACKGROUND: Percutaneous vertebroplasty has been gradual y used to treat Kümmel disease because of less trauma and quick pain relief, but there is stil a high rate of bone cement leakage. OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset for treatment of Kümmel ’s disease. METHODS: The clinical data of 17 patients with Kümmel ’s disease were retrospectively analyzed, including 5 males and 12 females, aged 55-83 years, and al underwent percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset. The visual analog scale, Oswestry disability index score, vertebral body height and vertebral kyphosis angle were determined. The bone cement leakage, pulmonary embolism, adjacent vertebral fractures and other complications were recorded. RESULTS AND CONCLUSION: At the 12th Oswestry disability index scores and vertebral kyphosis angle of patients were significantly lower than those before treatment (P < 0.05), the vertebral body height was significantly higher than that before month of follow-up, the visual analog scale scores, treatment (P < 0.05). After treatment, there were three cases of bone cement leakage, which had no special discomfort and neurological symptoms, and one case of new fractures. These results demonstrate that hyperextension position reset combined with percutaneous vertebroplasty with high-viscosity bone cement in treatment of Kümmel ’s disease can effectively relieve back pain, improve function of the lower back, partial y restore vertebral height and reduce kyphosis angle.

As a biomaterial to be used for reparation in the case of trauma, the silk fibroin, particularly its effect on the transcription and expression of VEGF gene, is a concern. In this study, the ECV304 cell's growth shape and growth curve on the regenerated silk fibroin film were observed, and its VEGF secretion level was measured by ELISA test. It was found that the regenerated silk fibroin film did not interfere with ECV304 cell's growth and function. The L929 cell transfected with human VEGF gene grew on the regenerated silk fibroin film; the real-time quantitative RT-PCR method and ELISA test were used for detecting the transcription and expression of VEGF gene. The results showed the regenerated silk fibroin film did not interfere with the transcription and expression of VEGF gene. Therefore, the regenerated silk fibroin film is a safe biomaterial for inducing vascularization with no untoward effect on the reparation of trauma.
Animals ; Biocompatible Materials ; pharmacology ; Cell Line ; Endothelial Cells ; cytology ; metabolism ; Fibroins ; pharmacology ; Humans ; Silk ; pharmacology ; Transcription, Genetic ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.
China ; Health Services Needs and Demand ; Primary Health Care ; organization & administration

OBJECTIVE: To investigate the efficacy and safety of Mizolastine in the treatment of perennial allergic rhinitis. METHOD: Multicentric random Double-blind parallel-controlled study was adopted, and compared with placebo and Cetirizine. Patients (n = 177) were grouped, seventy-two in Mizolastine group, sixty-nine in Cetirizine and thirty-six in placebo group. RESULT: In the seventh curative day symptomatic and sign marks in Mizolastine group and Cetirizine group were lower, but the mark in Mizolastine group reduced more than in Cetirizine group and placebo group. Mizolastine group is better than Cetirizine group in improvement of nasal obstruction and itching with Visual analogue scale. In the twenty first curative day reduction of symptomatic and sign marks in Mizolastine group was lower than Cetirizine group, but no statistic difference. There were 27 adverse events, no serious adverse events in 177 patients during experimental period. Most adverse events were headache and dryness in mouth and eyes. There were 10 cases adverse events in Mizolastine group, one case was related with experiment and four cases might be related with experiment. There were 14 cases adverse events in Cetirizine group, one case was related with experiment and four cases might be related with experiment. There were three cases adverse events in placebo group. CONCLUSION Generally speaking the efficacy of Mizolastine in treatment of perennial allergic rhinitis is better than Cetirizine, Bad events are less. It is safe.
Adolescent ; Adult ; Aged ; Benzimidazoles ; adverse effects ; therapeutic use ; Cetirizine ; therapeutic use ; Child ; Double-Blind Method ; Female ; Histamine H1 Antagonists, Non-Sedating ; adverse effects ; therapeutic use ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic, Perennial ; drug therapy ; Treatment Outcome ; Young Adult

With the continuous evolution and refinement of the healthcare insurance system,there arises a heightened de-mand for the standardization and efficacy of healthcare insurance management.This paper takes a prominent public hospital in Guangzhou City as a case study to delve into the establishment and enhancement of an intelligent monitoring system for healthcare insurance.Initially,an analysis is conducted from the perspectives of the national,policy,and institutional levels to underscore the imperative and urgency of constructing an intelligent monitoring system for healthcare insurance.Subsequently,a comprehen-sive review of the current research landscape,both domestically and internationally,is presented,highlighting the challenges faced by domestic intelligent auditing systems in terms of their level of intelligence,the sophistication of hospital-level intelligent monitoring,and the standardization of rule libraries.Following this,the paper elaborates on the practical endeavors undertaken by large public hospitals in Guangzhou City regarding the construction and optimization of the intelligent monitoring system for healthcare insurance.This encompasses aspects such as the structure of the intelligent monitoring system,collaborative manage-ment in operational modes,and the standardization of rule libraries.Finally,the paper concludes by summarizing the positive im-pact of these practices on the regulation of medical service behaviors and the enhancement of efficiency in healthcare insurance quality management,while also offering insights into future research directions.

Objective To explore the early clinical effects of lumbar discectomy associated with annulus repair in the treatment of lumbar disc herniation.Methods A prospective study was conducted to review 56 patients with lumbar disc herniation who accepted discectomy surgery in Subei People's Hospital of Jiangsu Province from January 2014 to September 2015,including 28 cases of discectomy associated with annulus repair (repair group) and 28 cases of discectomy (control group).Oswestry disability index and visual analog scale scores were recorded.Simultaneously,incision length,operative time,blood loss,hospitalization time,surgical complications,and postoperative recurrence of lumbar disc herniation were recorded.Results All patients completed the follow-up for 12 to 18 months (14.5 ± 1.3).There was no difference between the repair and control groups in the incision length,blood loss and hospitalization time (P ＞ 0.05).The operative time of the repair group was longer than that of the control group,but the difference was not statistically significant (P ＞ 0.05).The Oswestry disability index and visual analog scale scores for lumbar and lower limb pain significantly decreased in both groups after surgery (P ＜ 0.05).The visual analog scale scores at 24 hours and 3 days after surgery in the repair group were less than that in the control group (P ＜ 0.05).The satisfactory rate of treatment in the repair group was slightly higher than that in the control group,but the difference was not statistically significant (P ＞ 0.05).There was no recurrence in the repair group,but 2 recurrence cases in the control group (P ＞ 0.05).Conclusions These findings indicate that discectomy associated with annulus repair is a safe and reliable method to obtain remarkable early clinical results and can reduce the recurrent rate in the treatment of lumbar disc herniation.